From the Research
It is crucial to exercise caution when combining CBD with Ritalin (methylphenidate) due to potential interactions that could affect morbidity, mortality, and quality of life, and medical supervision is highly recommended. The most recent and highest quality study 1 suggests that CBD may inhibit the carboxylesterase 1 enzyme, which metabolizes Ritalin, potentially leading to increased Ritalin levels in the bloodstream and enhancing both its therapeutic effects and side effects. This interaction could result in increased heart rate, blood pressure, anxiety, or insomnia. Additionally, both substances can affect dopamine levels in the brain, and their combined effect is not well understood.
Key Considerations
- The interaction between CBD and Ritalin varies between individuals based on factors like genetics, overall health, and other medications being taken.
- The study 1 used static and physiologically-based pharmacokinetic models to predict potential clinical significance and found that the inhibition of Ritalin hydrolysis by CBD was reversible.
- Another study 2 reported positive results in patients with ADHD who used cannabis, including improvements in symptoms and quality of life, but also noted mild adverse events.
Recommendations
- If considering using both CBD and Ritalin, consult a healthcare provider first to monitor for side effects and potentially adjust the Ritalin dosage if necessary.
- Start with low doses of CBD if approved by a doctor and pay attention to any changes in how you feel, particularly increased anxiety, heart palpitations, or changes in Ritalin's effectiveness.
- Be aware of the potential for increased heart rate, blood pressure, anxiety, or insomnia when combining CBD and Ritalin, as reported in the study 1.
- Consider the findings of the study 2 that reported improvements in symptoms and quality of life in patients with ADHD who used cannabis, but also be aware of the potential for mild adverse events.
Important Factors
- The study 3 aimed to explore the perceived effectiveness and pharmacokinetics of cannabis in youth and young adults with ADHD and oppositional defiant disorder, but the results are not yet available.
- The study 4 reported a case of a patient with ADHD who was treated with cannabinoid therapeutics, including Bedrocan and Bediol, and found improvements in symptoms, but this was a single case report.
- The study 5 discussed the importance of drug-drug interactions and the need for clinical judgment when interpreting alerts generated by drug interaction software.